高单不饱和脂肪酸型肠内营养剂用于2型糖尿病

目的探讨含高单不饱和脂肪酸的特殊类型肠内营养制剂(Glucerna)对2型糖尿病患者血糖、血脂等方面的影响。方法将60例行肠内营养支持的2型糖尿病患者随机分为对照组和研究组,采用间歇喂饲法,分别经鼻胃管重力滴注两种不同的肠内营养制剂(Nutrison和Glucerna),并于营养支持前、支持后第7、14天测定两组患者的空腹血糖(FBG)、餐后2小时血糖(2hBG)、糖化血红蛋白(GHb)、血清甘油三酯(TG)、胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)等指标。结果研究结束时,对照组FBG(7.57±2.12)mmol/L和2hBG(10.48±2.36)mmol/L比研究前略有升高,但差异不显著(P>0.05),GHb(7.47±1.22)%无明显改变(P>0.05)。研究组FBG和2hBG在营养支持后第7天已出现下降,到研究结束时分别降至(6.41±1.98)mmol/L和(9.20±2.38)mmol/L,明显低于研究前和对照组(P<0.05);GHb(7.05±0.78)%与研究前和对照组相比虽有所下降,但差异不显著(P>0.05)。整个研究期内两组患者血脂水平无明显变化(P>0.05)。结论高单不饱和脂肪酸型肠内营养制剂能够降低2型糖尿病患者的血糖水平,尤其是餐后血糖水平,在临床上比标准配方更适合糖尿病患者。

High-monounsaturated-fat Formula for Patients with Type 2 Diabetes Receiving Enteral Nutrition Support

Objective To evaluate the impact of Glucerna, a specialized formula with high-monounsaturated-fat content, on blood glucose and lipid in type 2 diabetic patients. Methods A prospective, randomized, double-blind clinical trial was performed. Sixty patients with type 2 diabetes receiving enteral nutrition support by nose-intestinal tube were randomly divided into the control group(receiving standard enteral formula Nutrison, Nutricia, Holland)and the study group(receiving a high-monounsaturated-fat formula Glucerna, Abbott, America). Fasting blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(GHb),serum triglycerid(TG),total cholesterol(TC),and LDL cholesterol(LDL-C)were monitored the 7th and the 14th days before and after study. Results All patients completed the whole study course without obvious adverse events. Compared with the control and the baseline, the FBG and GHb values in the study group were lower but not significant(P > 0.05), except for the PBG values(P < 0.05). Within the period of this study,the levels of blood lipid had no significant changes between the two groups(P > 0.05). Conclusions High-monounsaturated-fat formula Glucerna appears to have better glycemic control,especially postprandial blood glucose level in the type 2 diabetic patients. Glucerna was more suitable for diabetic patients than standard enteral formula.